St Joseph Regional Medical Center, Paterson, NJ, USA.
Tinitas Regional Medical Center, Paterson, NJ, USA.
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211014060. doi: 10.1177/23247096211014060.
Brugada syndrome is a rare arrhythmogenic syndrome that is associated with an increased risk of ventricular fibrillation and sudden cardiac death. Electrocardiographic findings include patterns similar to a right bundle branch block (RBBB) and persistent ST-segment elevation in precordial leads (V1 and V2). There are numerous reports of Brugada syndrome mimicking ST-segment elevation myocardial infraction (STEMI); however, we describe a case of 47-year-old male who presented with STEMI mimics Brugada syndrome with preexisting RBBB. The patient developed polymorphic ventricular tachycardia generating into ventricular fibrillation right before catheterization making the diagnosis more challenging. The patient, eventually, was found to have obstructive coronary artery disease and no evidence of abnormal sodium channelopathy on further testing. This case highlights the importance of meticulous history taking and appropriate diagnostic test in establishing proper diagnosis of STEMI in a patient with preexisting RBBB, which can mimic Brugada syndrome.
Brugada 综合征是一种罕见的心律失常综合征，与室颤和心源性猝死的风险增加相关。心电图表现包括类似于右束支传导阻滞（RBBB）的图形和前导导联（V1 和 V2）持续的 ST 段抬高。有许多 Brugada 综合征模拟 ST 段抬高型心肌梗死（STEMI）的报道；然而，我们描述了一个 47 岁男性的病例，他表现为 STEMI 模拟 Brugada 综合征伴预先存在的 RBBB。该患者在导管插入术之前发生多形性室性心动过速，进而发展为室颤，这使得诊断更加具有挑战性。最终，该患者被发现存在阻塞性冠状动脉疾病，进一步检查也没有发现异常钠离子通道病的证据。这个病例强调了在存在预先存在的 RBBB 的 STEMI 患者中，仔细询问病史和进行适当的诊断性检查对于正确诊断的重要性，这可能会模拟 Brugada 综合征。
